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SURGERY BOARDS > Liver > Flashcards

Liver Flashcards

1
Q

best test for vit k def and warfarin therapy

A

PT

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2
Q

Useful in determining liver faulure; shortest half life

A

Factor VIII

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3
Q

AST: ALT ratio

A

> 2:1

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4
Q

more specific for liver disease

A

ALT

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5
Q

Elevations point to extrahepatic causes

obstructive cholestasis

A

direct (conjugated bilirubin)

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6
Q

elevations point to intrahepatic cholestasis; hemolytic d/o

A

indirect (unconjugated bilirubin)

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7
Q

indicative of biliary obstruction

A

ALP

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8
Q

early marker and sensitive test for hepatobiliary disease

A

GGTP

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9
Q

JAUNDICE IS DETECTABLE WHEN SERUM BILIRUBIN IS MORE THAN ___

A

2.5-3 mg/dL

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10
Q

central arteriole with tiny radiating vessels, mainly on trunk and face

A

spider angiomata

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11
Q

cause of spider angiomata

A

elevated estradiol

decreased estradiol degradation in the liver

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12
Q

prominent veins radiating from umbilicus

A

caput medusae

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13
Q

epigastric vascular murmur

A

cruveilhier- Baumgarten syndrome

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14
Q

erythema sparing central portions of the palm

A

palmar erythema

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15
Q

cause of palmar erythema

A

inc estradiol

dec estradiol degradation in the liver

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16
Q

sweet pungent smell n liver failure

A

fetor hepaticus

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17
Q

spontaneous bacterial peritonitis

neutrophil count more than ___

A

250/ml

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18
Q

culture positive community acquired SBP

A

e. coli

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19
Q

culture positive nosocomial SBP

A

strep enterococcus

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20
Q

tx SBP

A

1ST line- cefotaxime

co- amox, quinolones

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21
Q

predicts the surgical risk of intra abdominal operations performed in px wth cirrhosis

A

child-turcotte-pugh score

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22
Q

normal portal pressure

A

5-10 mmhg

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23
Q

direct portal venous pressure >5mmhg of IVC pressure

splenic pressure more than 15

A

portal htn

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24
Q

pressure necessary for varices to form and bleed

A

> 12mmhg

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25
most accurate method of determining portal htn
hepatic venography
26
most significant manifestation of portal htn
esophageal varices ( left gastric vein)
27
mngt of acute esophageal variceal bleeding
vasopressin | octreotide- preferred
28
end to side porta caval shunt
eck fistula
29
large diameter interposition shunt
mesocaval; drapanas
30
proximal splenorenal shunt
Linton
31
total diversion of blood from PV to VC
NON SELECTIVE
32
partial diversion of blood from PV to VC
selective
33
for unsuitable for shunt procedures: transection of esophagus, splenectomy, truncal vagotomy and pyloroplasty ligation of venous branches of distal esophagus and the proximal stomach from the level of the inferior pulmonary vein
sugiura-fukugawa procedure
34
consists of: splenectomy perihiatal devascularization of the lower esophagus ligation of left gastric vessels devascularization of the proximal half of the stomach separation of stomach from its bed
Hassab procedure
35
congestive hepatopathy characterized by obstruction to hepatic venous outflow
Budd-Chiari syndrome
36
affects YOUNG WOMEN with MYELOFIBROSIS Factor V Leiden mutation anti cardiolipin antibodies hypermomocysteinemia
Budd-Chiari syndrome
37
tx Budd-Chiari syndrome
systemic anti coagulation
38
DX Budd-Chiari syndrome
INITIAL: abd UTZ Definitive: hepatic venography
39
MC route of hepatic exposure to bacteria
Ascending- biliary tree
40
which lobe is more commonly affected in pyogenic liver dse
Right lobe
41
mc gram neg organism in pyogenc liver abscess
E. Coli
42
causative agent amebic liver abscess
Entamoeba histolytica
43
infective stage of E. histolytica
cyst
44
pathogenic stage of E. histolytica
trophozoite
45
usual location of amebic liver disease
superior-anterior aspect of right lobe
46
mildly elevated Alkaline phosphatase | (+)fluorescent antibody test
AMEBIC LIVER ABSCESS
47
Caused by echinococcus granulosus
hydatid disease
48
MOT: ova containing feces (dog)
hydatid disease ova- intestines adult cyst- liver
49
dx for hydatid disease
ELISA for echinococcal antigens
50
well defined lesion with ring-like calcifications
hydatid disease
51
sx tx hydatid disease
complete cyst removal with instillation of scolicidal agent
52
med tx hydatid disease
Albendazole
53
most frequently encountered liver lesion overall
hepatic cyst
54
tx of heaptic cyst
asymptomatic- observe | symptomatic: percutaneous aspiration and sclerotherapy
55
most common benign solid masses in the liver
hemangioma
56
tx of hemangioma
enucleation
57
asymmetrical peripheral enhancement with progressive centripetal enhancement
hemangioma
58
benign solid liver mass | assoc with women using OCP
Adenoma
59
benign liver mass with spontaneous rupture and hemorrhage and malignant degeneration
adenoma
60
benign liver mass usually DO NOT spontaneously rupture and hemorrhage and malignant degeneration
focal nodular hyperplasia
61
nuclear scan- cold
adenoma
62
nuclear scan- hot
focal nodular hyperplasia
63
metastatic liver tumors usally are from__
colon
64
mc malignant liver tumor
metastatic
65
criteria for liver transplant
MILAN
66
Tumor in the bifurcation of right hepatic duct
Klatskin tumor

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